Totally implantable venous access ports: a prospective long-term study of early and late complications in adult patients with cancer
- 765 Downloads
Totally implantable venous access ports (TIVAP) have been widely used for many years in the management of patients suffering from cancer. The implantation and long-term use of TIVAPs are associated with mechanical, thrombotic, and infectious complications. This is the first exhaustive prospective study of all complications occurring in a whole population on long-term follow-up and therefore allows an objective assessment to be made of the safety of TIVAPs.
We carried out a prospective single-center observational study. All adult patients with cancer who had a TIVAP implanted between January 1 and December 31, 2006 were registered. Early and late complications were recorded until the removal of the device, the patient’s death, or until December 31, 2013. Exhaustive data concerning patients and TIVAP was recorded at time of implantation.
Four hundred and ninety-three TIVAPs were implanted in 483 adult cancer patients and were followed during a period from 1 to 94 months (median = 18 months) representing a global quantity of 367,359 catheter-days. Eighty-seven complications were recorded (0.237/1000 catheter-days), including 37 infections (0.101/1000 catheter-days), 17 thrombotic events (0.046/1000 catheter-days), and 9 extravasations. Out of the 87 events, 62 (71.3%) occurred during the first year after implantation. Events were therefore extremely rare after 1 year. Thromboembolic and infectious complications were rare and no risk factors for these were found.
This study demonstrates excellent tolerability, with only occasional complications. Most of these occurred during the year following implantation. A TIVAP may also be left in place for an extremely long time.
KeywordsTotally implantable venous access port Complications Long-term follow-up Thromboses Infections Cancer chemotherapy
Compliance with ethical standards
Conflict of interest
The research has not been sponsored. The authors declare that they have no conflict of interest.
We have full control of all primary data and allow the journal to review all the data.
- 4.Lebeaux D, Larroque B, Gellen-Dautremer J, Leflon-Guibout V, Dreyer C, Bialek S, Froissart A, Hentic O, Tessier C, Ruimy R, Pelletier AL, Crestani B, Fournier M, Papo T, Barry B, Zarrouk V, Fantin B (2012) Clinical outcome after a totally implantable venous access port-related infection in cancer patients: a prospective study and review of the literature. Medicine 91(6):309–318CrossRefGoogle Scholar
- 5.Biffi R, Pozzi S, Agazzi A, Pace U, Floridi A, Cenciarelli S, Peveri V, Cocquio A, Andreoni B, Martinelli G (2004) Use of totally implantable central venous access ports for high-dose chemotherapy and peripheral blood stem cell transplantation: results of a monocentre series of 376 patients. Ann Oncol 15:296–300CrossRefGoogle Scholar
- 8.Hull RD, Hirsh J, Carter CJ, Jay RM, Dodd PE, Ockelford PA, Coates G, Gill GJ, Turpie AG, Doyle DJ, Buller HR, Raskob GE (1983) Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 98(6):891–899CrossRefGoogle Scholar
- 13.Biffi R, Orsi F, Pozzi S, Pace U, Bonomo G, Monfardini L, Della Vigna P, Rotmensz N, Radice D, Zampino MG, Fazio N, de Braud F, Andreoni B, Goldhirsch A (2009) Best choice of central venous insertion site for the prevention of catheter-related complications in adult patients who need cancer therapy: a randomized trial. Ann Oncol 20(5):935–940CrossRefGoogle Scholar
- 15.Heibl C, Trommet V, Burgstaller S, Mayrbaeurl B, Baldinger C, Koplmüller R, Kühr T, Wimmer L, Thaler J (2010) Complications associated with the use of Port-a-Caths in patients with malignant or haematological disease: a single-centre prospective analysis. Eur J Cancer Care 19(5):676–81CrossRefGoogle Scholar
- 18.Joks M, Czyz A, Poplawski D, Komarnicki M (2014) Incidence and risk factors for centrral venous catheter-related thrombosis in hematological patients. Med Oncol 31(1):772Google Scholar